Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross sectional study

Abstract

BackgroundDegenerative musculoskeletal disorders are among the most frequent diseases occurring in adulthood, often impairing patients' functional mobility and physical activity. The aim of the present study was to investigate and compare the impact of three frequent degenerative musculoskeletal disorders -- knee osteoarthritis (knee OA), hip osteoarthritis (hip OA) and lumbar spinal stenosis (LSS) -- on patients' walking ability.MethodsThe study included 120 participants, with 30 in each patient group and 30 healthy control individuals. A uniaxial accelerometer, the StepWatch™ Activity Monitor (Orthocare Innovations, Seattle, Washington, USA), was used to determine the volume (number of gait cycles per day) and intensity (gait cycles per minute) of walking ability. Non-parametric testing was used for all statistical analyses.ResultsBoth the volume and the intensity of walking ability were significantly lower among the patients in comparison with the healthy control individuals (p < 0.001). Patients with LSS spent 0.4 (IQR 2.8) min/day doing moderately intense walking (>50 gait cycles/min), which was significantly lower in comparison with patients with knee and hip OA at 2.5 (IQR 4.4) and 3.4 (IQR 16.1) min/day, respectively (p < 0.001). No correlations between demographic or anthropometric data and walking ability were found. No technical problems or measuring errors occurred with any of the measurements.ConclusionsPatients with degenerative musculoskeletal disorders suffer limitations in their walking ability. Objective assessment of walking ability appeared to be an easy and feasible tool for measuring such limitations as it provides baseline data and objective information that are more precise than the patients' own subjective estimates. In everyday practice, objective activity assessment can provide feedback for clinicians regarding patients' performance during everyday life and the extent to which this confirms the results of clinical investigations. The method can also be used as a way of encouraging patients to develop a more active lifestyle.

Factors associated with mobility of the oldest old

“…This same study af irms that diabetes has a greater in luence on disability than hypertension. Winter et al (30) observed that individuals with osteoarticular diseases have less mobility than their healthy peers. In this study none of the investigated diseases (hypertension, diabetes and osteoarticular diseases) were associated with the mobility of the oldest old.…”

Brain-derived neurotrophic factor expression in dorsal root ganglia of a lumbar spinal stenosis model in rats

“…With the development of imaging methods and the increased aging of society, the incidence of LSS has shown an annual increase. LSS is one of the main causes of leg pain in older individuals (1)(2)(3)(4), including intermittent claudication, numbness of buttocks and legs, activity disorder of waist and legs, muscle wasting and tendon dysreflexia (5). Intermittent claudication caused by neuropathic pain (NP) is a special chief complaint of LSS, which may be reconstructed by clinical workers; however, its mechanisms remain unclear.…”

Objective Measurement of Free-Living Physical Activity (Performance) in Lumbar Spinal Stenosis: Are Physical Activity Guidelines Being Met?

“…Lumbar spinal stenosis is characterized by neurogenic claudication and mobility limitations [1][2][3]17,18]. Yet, despite the fact that neurogenic claudication is the hallmark of LSS, the effects of symptoms on free-living physical activity (performance) are not well understood.…”

“…Fortunately, recent advances in wearable technology have provided us with the tools to objectively measure free-living physical activity (performance) in people with LSS. Using accelerometers, we are beginning to understand more about performance in this population [1][2][3]20,21]. Some preliminary work with pedometers demonstrated that people with LSS take an average of around 4,000 steps/day [17], which is considered sedentary [22].…”

“…Lumbar spinal stenosis (LSS) is a painful, debilitating condition [1][2][3][4][5][6][7][8] with an estimated prevalence of 9% in the general population, and up to 47% in people over age 60 [9]. Lumbar spinal stenosis is the most common reason for spine surgery in patients over 65 [10], with a current estimated 2-year cost of $4 billion in the United States [11,12].…”